This application is the U.S. national phase application of PCT International Application No. PCT/EP2010/050237, filed Jan. 12, 2010, which claims priority to Austrian Patent Application No. A46/2009, filed Jan. 13, 2009, the contents of these applications being incorporated fully by reference herein.
The invention relates to a device for measuring at least one parameter of an arterial blood sample.
To take a blood sample in an intensive care unit, for instance, when the patient has already been provided with an arterial access system, blood is manually aspired by means of an aspiration piston of the infusion set and withdrawn by means of a one-way syringe via the septum of the infusion set. The blood sample is then analysed in an external blood gas analyser or sent to a laboratory for analysis after transfer into a tubule. Withdrawal via the septum presents a certain risk of injury or infection for patient and personnel, and transport to the external blood gas analyser or sending to the laboratory may entail errors due to wrong labelling or confounding of samples.
In this context it has become known to measure certain blood parameters directly on the patient. U.S. Pat. No. 4,989,606 A discloses an intravascular blood gas measuring system in which a tube communicating with the vascular system of the patient is directly connected to a sensor unit. The sensor unit comprises a flow-through sensor with fluorescence-optical sensors, for instance for measuring O2 and CO2 concentration and blood pH. On the outlet side of the flow-through sensor a tube is provided which connects to a pressurized bag containing a heparinized saline solution. The tube connected to the pressurized bag is provided with an adjustable drip valve and a manually actuated flushing valve.
The flow-through sensor of U.S. Pat. No. 4,989,606 A is held in a transmitter unit containing a thermostatting device for the blood sample and a number of light guides, which provide excitation radiation for the optical sensors and transmit the measured radiation. The whole sensor unit, which is attached to the patient's arm, is heavy and relatively bulky and frequently causes irritation when used. Moreover, the measuring system cannot be integrated into conventional infusion sets.
From EP 0 994 669 B1 a system for measuring blood parameters has become known, which may be used in an extracorporeal circulation system (heart-lung machine) during surgery. The system comprises a flow-through cartridge with a chamber receiving the blood sample, the cartridge containing at least one optical sensor. There is furthermore provided an apparatus for releasable connection of the cartridge, which contains a light source for exciting the sensor and a light detector for receiving the light emitted by the sensor and at least one signal transducer connected to the light detector. The signal transducer provides a digital output signal, which changes in accordance with the amount of light detected by at least one light detector. The disadvantages cited in the context of U.S. Pat. No. 4,989,606 will also prevail here, i.e. the device is bulky and cannot be integrated into conventional infusion sets.
Finally there is known from U.S. Pat. No. 4,830,013 A an intravascular measuring system for blood parameters, which comprises a catheter unit at whose distal end optical sensors for measuring blood gases (O2- and CO2-concentration, pH-value) are provided, each sensor sitting at the tip of a light guide.
An aspect of the present invention provides a device for measuring at least one parameter of an arterial blood sample, which has small volume and may easily be used with conventional arterial access systems.
According to aspects of the invention parameter measurement is achieved by an apparatus with the following components:
A device according to aspects of the invention may be perfectly integrated in the clinical work procedure, since application of the measuring system only requires releasing of the standardized connection between arterial catheter and arterial infusion set and plugging-in of the system of the invention. The electronic module supplying power to the light sources and photodetectors in the connector, is connected to an evaluation and display unit via a flexible electrical lead, but could also be furnished with a wireless link, avoiding the necessity of a cable connection to the evaluation and display unit. The flow-through sensor together with the connector can be attached to the patient's arm, with the electronic module either also being attached to the arm or being integrated in the evaluation and display unit.
In an advantageous variant of the invention a preferably optical measuring element may be provided in the measuring cell of the flow-through sensor, which upon contact with the blood sample sends a starting signal to activate parameter measurement.
The invention will now be described in more detail with reference to the enclosed drawings:
A state-of-the-art arterial access system for taking a blood sample for blood analysis, has an arterial catheter 1 and an arterial infusion set 16 which may be directly plugged onto the catheter. At the outlet side of the infusion set there is a pressure bag 20 (schematically drawn) containing a heparinized flushing solution, for instance.
To carry out blood analysis a blood sample must be taken, which requires the following steps of procedure:
The manually adjustable drip valve of the infusion set is referred to as 25. The arterial catheter 1 and the infusion set 16 are provided with standardized fittings 14, 15, for instance Luer adaptors, by means of which the components 1 and 16 are connected so as to be fluid- and gas-tight in a well-known way.
In contrast to the above, the measuring system according to aspects of the invention as shown in
The flow-through sensor 2 of the device according to aspects of the invention has standardized connecting elements 3 and 4, for instance Luer adaptors, which connect to the inlet and outlet side 5, 6 of the measuring cell 7 of the flow-through sensor 2. In the measuring cell 7 there are located optochemical sensor elements 8, which can be brought into contact with the blood sample; in
The device is furthermore provided with a connector 9, which can detachably be plugged onto the flow-through sensor 2 and is furnished with at least one light source 10 for excitation of the optochemical sensor element 8 and with a photodetector 11 for receiving the measuring radiation emitted by the sensor element 8. The measuring system can be operated at low cost, since the flow-through sensor can simply be exchanged when the device is to be used for a new measuring process.
As is further shown in
The electronic module 12, which establishes electrical contact with the light sources 10 and the photodetectors 11 in the connector 9, communicates via an electrical line 17 or by a wireless link with an evaluation and display unit 18. As shown schematically in
In the variant of the device of the invention shown in
According to a variant of the invention a preferably optical measuring device may be provided in the measuring cell 7 of the flow-through sensor 2, which generates a starting signal to activate parameter measurement on contact with the blood sample. This device will also quickly detect blood which enters the sampling system by mistake, and will activate a corresponding optical or acoustical warning signal at the evaluation and display unit 18, 18′ and initiate flushing of the catheter, if desired.
For blood analysis with the device of the invention only the following steps are performed:
It is also possible to schedule measurements at predetermined time intervals by means of an automated system, aspiration of the blood sample into the measuring cell 7 of the flow-through sensor 2 being carried out by an automatically actuated piston- or peristaltic pump (not shown in the drawing).
According to aspects of the invention the measuring cell 7 of the flow-through sensor 2 may additionally be provided with a sensor for temperature measurement. Preferably the measurement is started only after the blood sample has come to rest. The automatic start of measurement may thus be coupled with a measurement of temperature. The flow rate or standstill of the blood sample may for instance be determined from the temperature gradient measured. The principle involved is that as long as the aspired blood moves the temperature will rise. When the blood in the measuring cell stops moving the temperature will begin to drop. The optimum starting point of measurement may thus be better determined and controlled, which will improve measurement accuracy.
Preferably the measuring cell 7 of the flow-through sensor is also provided with at least one sensor for measuring a parameter from the group O2, CO2, pH, sodium, potassium, glucose, lactate and temperature.
Advantages of the measurement system according to aspects of the invention include:
Number | Date | Country | Kind |
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A 46/2009 | Jan 2009 | AT | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/EP2010/050237 | 1/12/2010 | WO | 00 | 7/13/2011 |
Publishing Document | Publishing Date | Country | Kind |
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WO2010/081789 | 7/22/2010 | WO | A |
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Number | Date | Country | |
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20110275913 A1 | Nov 2011 | US |